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Evaluation of the WHO standards to assess quality of care for children with acute respiratory infections: findings of a baseline multicentre assessment (CHOICE) in Italy.
Lazzerini, Marzia; Dagnelut, Massimo; Dalena, Paolo; Sforzi, Idanna; Toniutti, Maristella; Felici, Enrico; Bressan, Silvia; Trobia, Gian Luca; Martelossi, Stefano; Lubrano, Riccardo; Fasoli, Silvia; Marchetti, Federico; Iuorio, Andrea; Grisaffi, Chiara; Galiazzo, Silvia; Patanè, Francesca; Stefani, Chiara; Casciana, Maria Luisa; Troisi, Angela; Barbi, Egidio.
Afiliación
  • Lazzerini M; Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
  • Dagnelut M; London School of Hygiene & Tropical Medicine, London, UK.
  • Dalena P; University of Trieste, Trieste, Italy.
  • Sforzi I; Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy paolo.dalena@burlo.trieste.it.
  • Toniutti M; University of Trieste, Trieste, Italy.
  • Felici E; Department of Pediatric Emergency Medicine and Trauma Center, Meyer Children's Hospital IRCCS, Florence, Italy.
  • Bressan S; Santa Maria della Misericordia University Hospital, Udine, Friuli-Venezia Giulia, Italy.
  • Trobia GL; Azienda Ospedaliera Nazionale Santi Antonio e Biagio e Cesare Arrigo Alessandria, Alessandria, Piemonte, Italy.
  • Martelossi S; Department of Women's and Children's Health, University of Padova, Padova, Italy.
  • Lubrano R; Cannizzaro Hospital, Catania, Sicilia, Italy.
  • Fasoli S; Department of Pediatrics, Treviso Hospital, Treviso, Italy.
  • Marchetti F; Department of Pediatrics Sapienza University of Rome, Santa Maria Goretti Hospital, Latina, Italy.
  • Iuorio A; Department of Pediatrics, "Carlo Poma" Hospital, Mantova, Italy.
  • Grisaffi C; Department of Pediatrics, Santa Maria delle Croci Hospital, Ravenna, Italy.
  • Galiazzo S; Pediatric Hematology and Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico di Sant'Orsola, Bologna, Italy.
  • Patanè F; Azienda Ospedaliera Nazionale Santi Antonio e Biagio e Cesare Arrigo Alessandria, Alessandria, Piemonte, Italy.
  • Stefani C; Department of Women's and Children's Health, University of Padova, Padova, Italy.
  • Casciana ML; Santa Marta e Santa Venera Hospital, Acireale Catania, Italy.
  • Troisi A; Department of Pediatrics, Treviso Hospital, Treviso, Italy.
  • Barbi E; Department of Pediatrics, "Carlo Poma" Hospital, Mantova, Italy.
BMJ Paediatr Open ; 8(Suppl 7)2024 Aug 30.
Article en En | MEDLINE | ID: mdl-39214560
ABSTRACT

BACKGROUND:

Experience is lacking on the implementation of the WHO standards for improving the quality of care (QOC) for children at facility level. We describe the use of 10 prioritised WHO standard-based quality measures to assess provision of care for children with acute respiratory infections (ARI) in Italy.

METHODS:

In a multicentre observational study across 11 emergency departments with different characteristics, we collected 10 WHO standard-based quality measures related to case management of children with ARI and no emergency/priority signs. Univariate and multivariate analyses were conducted.

RESULTS:

Data from 3145 children were collected. Major differences in QOC across facilities were observed documentation of saturation level and respiratory rate varied from 34.3% to 100% and from 10.7% to 62.7%, respectively (p<0.001); antibiotic prescription rates ranged from 22.6% to 80.0% (p<0.001), with significant differences in the pattern of prescribed antibiotic; hospitalisations rates ranged between 2.3% and 30.6% (p<0.001). When corrected for children's individual sociodemographic and clinical characteristics, the variable more consistently associated with each analysed outcome was the individual facility where the child was managed. Higher rates of antibiotics prescription (+33.1%, p<0.001) and hospitalisation (+24.7%, p<0.001) were observed for facilities in Southern Italy, while university centres were associated with lower hospitalisation rates (-13.1%, p<0.001), independently from children's characteristics.

CONCLUSIONS:

The use of 10 WHO standard-based measures can help quickly assess QOC for children with ARI. There is an urgent need to invest more in implementation research to identify sustainable and effective interventions to ensure that all children receive high QOC.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones del Sistema Respiratorio / Organización Mundial de la Salud / Antibacterianos Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male País/Región como asunto: Europa Idioma: En Revista: BMJ Paediatr Open Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones del Sistema Respiratorio / Organización Mundial de la Salud / Antibacterianos Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male País/Región como asunto: Europa Idioma: En Revista: BMJ Paediatr Open Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Reino Unido